Unit 1 Day 7 Tue. (3/31/15) Flashcards Preview

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Flashcards in Unit 1 Day 7 Tue. (3/31/15) Deck (15):
1

  • persistent slow rate from SA node
  • rate = 55bpm
  • PR interval = 180ms

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Sinus Bradycardia

2

  • failure of sinus node to discharge resulting in the absence of atrial depolarization and periods of ventricular asystole
  • rate= 75 bpm
  • PR interval = 180 ms

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Sinus Arrest

3

  • intermittent episodes of slow and fast rates from the SA node or atria

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Brady Tachy

4

Tx for AV Block

  • tx reversible causes: ischemia, infarction, hypothyroidism, Lyme disease
  • stop offending medications
  • acute tx fo unstable pt: 
    • beta agonists (dopamine or isoproterenol)
    • transcutaneous pacing
    • temporary transvenous pacing
    • long term: pacemaker

5

Where in the conduction system can bradyarrhythmias develop?

  • sinus node
    • sinus bradycardia
    • sinus arrest
    • tachy brady
    • chronotropic incompetence
  • AV node
    • first degree AV block
    • mobitz 1/Wenkebach
  • below AV node (infranodal/His Purkinje system)
    • mobitz 2 2nd degree AV block (intermittently dropped ventricular beats with constant PR intervals)
    • complete heart block

6

Sinus Node Dysfunctions

  • sinus bradycardia
  • sinus arrest/pause
  • tachy/brady
  • chronotropic incompetence- inability to mount age-appropriate HR with exercise

7

AV Node Conduction Problems

  • first degree AV block
  • mobitz 1/ wenkebach (inc. PR interval)

8

Infranodal Dysfunctions

  • mobitz 2 2nd degree AV block (intermittently dropped ventricular beat with constant PR intervals)
  • complete heart block

9

Tachyarrhymia Origin

  • above ventricle
    • supraventricular tachycardias (SVT)
      • regular
        • ST
        • AVNRT
        • AVRT
        • AFL
        • AT
        • JT
      • irregular
        • AF
        • MAT
        • AFL
  • ventricle
    • ventricular tachycardia
    • ventricular fibrillation

10

Tx for Supraventricular Tachycardias

  • ST
  • AVNRT
  • AVRT
  • AFL
  • AT JT

  • adenosine

11

Tx for Irregular Supraventricular Tachycardia

  • AF
  • MAT
  • AFL

  • rate control
  • antiarrhythmics
  • cardioversion
  • if unstable, shock

12

Ventricular Tachyarrhythmias Treatment

  • common with coronary artery disease
  • stable
    • meds
      • amiodarone
      • lidocaine
      • procainamide
      • tx underlying causes
  • unstable
    • shoch
    • tx underlying causes
    • medications

13

Tx for Sudden Cardiac Death

  • BLS
  • early defibrillation

14

Rhythm Control

  • to achieve and maintain sinus rhythm (cardioversion)
  • try first in pts who are
    • symptomatic
    • younger
    • presenting for first time with lone AF
    • secondary to treated precipitant
    • w/ congestive HF
  • more likely to succeed if
    • recent onset AF
    • no structural heart disease
    • tx precipitating causes
    • young age
    • acute onset AF (MI)

15

Rate Control

  • to achieve resting HR 60-80/min
  • to reduce undue inc. of HR during exercise
  • pts unsuiable for cardioversion
  • all pts with rapid AF initially to relieve sx
  • control achieved in slowing
    • resting HR
    • HR during exercise